[BjoernKW]

In Germany, for example, medical records are scattered across medical practitioners, hospitals and health insurance providers. There's no central, distributed or federated EMR system. Each practice or hospital basically runs its own system, sometimes dating from the 1980s. MS-DOS is still widely used in surgeries.

Data transfer (i.e. lab results, consultation results) happens mostly on paper, that is the patient usually gets handed a letter with the results to present to their GP.

Lots of information is lost this way. Examinations and analyses often are duplicated or done repeatedly.

[allendoerfer]

> Lots of information is lost this way.

Which is also a privacy feature. Your dentist has your records, if a body is found and they think it might be you, they will ask your dentist for the records. If the mandatory storage period has passed, they are gone. To steal the records, an attacker would have to know, who your dentist is and then get them from there.

[BjoernKW]

The same kind of system could be implemented with a distributed or federated EMR.

The data would still be stored with the practitioner where it originated but it could be shared with third parties (i.e. other practitioners) if the patient consents.

I really don't see how using the patient as messenger for medical data on paper could be seen as a privacy feature. Quite to the contrary, actually: Paper documents are easily misplaced or lost and then suddenly someone has access to your medical data.

[DataWorker]

How great for the patient. Everywhere you have built in second opinions. With digital, one lazy or bad doctor can more or less permanently alter the course of subsequent medical care with inaccurate information or a bad diagnoses.

[amolo]

how different is it for paper based records then? What advantage does paper even have.

[jklein11]

It is easier for you as a patient to control your paper record. You can just throw out an opinion that doesn't seem right. If your record is being managed for you, it is much harder to get things corrected.

[BjoernKW]

This is simply a question of ownership and control. If you own and control your medical data you can simply share it with medical practitioners when required.

With the current system on the other hand I have very limited control over my medical data, if at all.

Sure, when receiving results on paper I could throw away anything I "don't like".

However, I have no control over what records my GP, a hospital, or my health insurance provider keep about me. I can't see them. I can't have them amended or deleted.

[Spooky23]

You can see it and correct it.

Every time my local medical cartel upgrades their EMR, my personal history gets amended to include false information that could have impacts on my career, and lead a provider to make a bad decision.

[martin_a]

Ah come on, it's not that bad anymore. My mother recently had some x-rays done because of a broken knee and all the files were sent digitally to the doctor and he forwarded them to a specialist. So, it's not that bad...

[BjoernKW]

The last time I got a PET scan (about 3 years ago) they handed me a CD with the images and an accompanying piece of paper with a summary of the results. At least that CD included a DICOM viewer for macOS as well so I could have a look at the images myself.

It's the same with other medical imaging procedures. They have machines literally costing millions but they can't afford to have a secure system for keeping and exchanging medical data.

Up until a few years ago (according to my knowledge, perhaps this is still happening) paramedics routinely used WhatsApp for sending information to A&E while en route because there simply is no proper system in place to do so.

[martin_a]

Hm, not sure, maybe this differs from doctor to doctor. To be honest, I was also suprised when she told me that as she lives in a rather rural area and not some big town. But at least that hospital/doctors seem to be really up to date with their tech.